Is epidural analgesia associated with an improved outcome following open Nissen fundoplication?

Postoperative epidural analgesia is increasingly popular in paediatric prac tice, although evidence of its benefit is scarce. We performed a retrospect ive analysis of a series of 104 consecutive open Nissen fundoplications, to determine whether mode of analgesia, epidural (n = 65) or opioid infusion (n = 39), influenced certain outcome measures, including intensive care uti lization, duration of hospital stay, morbidity and mortality. The two group s were similar in terms of demographic characteristics and associated patho logies. Overall, morbidity and mortality (2%) rates were low. Mean duration of hospital stay was significantly greater for the opioid group, compared to those receiving epidural analgesia (13 vs. 8 days, P < 0.05). The number of patients who remained in hospital for more than 7 days was also signifi cantly greater in the opioid group. Accepting the limitations of a retrospe ctive study, these data suggest that epidural analgesia might be associated with an improved outcome following Nissen fundoplication and this merits a prospective study.